Fad diets come and go — remember the low-fat craze of the ‘80s?
Today, two of the hottest diets are keto and vegan, but while those eating plans immediately make people think of weight loss, they also can have considerable heart health benefits. The trick is not just eliminating certain foods, but also making sure to replace them with healthy, nutrient-packed alternatives.
“Some people on a plant-based diet assume that a food labeled ‘vegan’ is automatically good for you, but scarfing down vegan cupcakes brings its own problems,” points out Tracy Severson, a registered and licensed dietitian with OHSU Knight Cardiovascular Institute’s Center for Preventive Cardiology.
A vegan diet avoids all animal products. Done right, it can help mitigate high cholesterol, a contributor to cardiovascular disease. First, eating vegan eliminates a large amount of saturated fat, a key contributor to unwanted LDL cholesterol, and completely eliminates dietary cholesterol that is found only in animal products. Second, a vegan diet’s high fiber content helps with portion control, since fiber can make you feel fuller, faster.
While no cardiac conditions would prohibit the adoption of a vegan diet, Severson cautions that “vegan” doesn’t always equate to “heart-healthy.” Potato chips, soda pop and coconut-based foods, while technically vegan, can contribute a big dose of salt, sugar and unhealthy fats.
Severson sees veganism as a smart choice for people who are committed to planning meals to make sure they’re well-balanced and include plant-based proteins, such as beans and lentils, and soy sources like tofu and edamame. She notes that even partially following a vegan diet has benefits. “Even just one day a week can put you on the right path,” she says.
The keto diet is less forgiving, says Monica Walker, a Hillsboro-based nutritionist. “I’ve seen fads come and go, and while keto might be all the rage, it can also be a way of life depending on your health status and lifestyle.”
Put simply, a ketogenic diet is based on an eating plan that is low in carbohydrates and high in fat with low to moderate amounts of protein. With a reduced intake of net carbohydrates (total carbs minus fiber) and increased fat intake, the body can be forced to convert and burn fat for energy, a process called ketosis. To go keto, eat a moderate amount of protein, increase consumption of healthy fats and reduce carbohydrate intake. (Dreamstime) Walker cautions that this plan can be extremely difficult to stick to. “With most diets you can go to a birthday party or plan a weekly ‘cheat meal,’ but with the ketogenic diet, it’s all or nothing.” She recommends would-be keto participants educate themselves and set aside ample time to select foods and prep meals to set themselves up for success.
With any drastic change in eating habits, sustainability can be a big question mark — what might seem appealing for a few weeks can be challenging to continue indefinitely, points out Dr. Jamie Beckerman, a cardiologist with Providence Heart and Vascular Institute and medical director of its Center for Prevention and Wellness. “The decision to pursue a diet like this should be done thoughtfully regarding how you would approach different eating situations.”
That said, both think a keto diet can offer heart-healthy benefits, particularly to folks who struggle with their blood sugar levels. That’s because when you break down a keto diet to its essential components, it’s basically eating a low-sugar, low-carbohydrate diet, Beckerman says. The key is what you replace the carbs with, he says, such as favoring lean meat over highly processed bacon.
Walker finds that without supervision, a keto diet can easily turn into a “bacon and butter” diet, which sends patients’ cholesterol skyrocketing. She stresses that a keto diet is not a license to eat poor sources of fat; among the foods she recommends are grass-fed beef and seafood, with fat from nuts and coconut oil. These foods can raise desirable HDL and lower triglycerides.
Walker also recommends that a qualified nutritionist or dietitian supervise a keto diet. Specifically, those with a personal or family history of high cholesterol or high blood pressure should follow the keto diet only with healthy fats — such as those from plants and fish — and should eliminate or limit fats from animal products, such as dairy and red meat.
Those who should avoid the keto diet include people with insulin-dependent diabetes, fatty liver disease or kidney disease; people with a history of eating disorders; people whose gallbladders have been removed; and pregnant women.
In addition, high-fat diets can either inhibit or enhance absorption of medications, so people who take prescription drugs should check with a doctor or pharmacist to address potential side effects from following a keto diet.
Beckerman notes that because the keto diet is relatively new, there has been no way to gather data on its long-term effects.
The bottom line, says Beckerman, is that there is no drawback to pursuing a heart-healthy diet, whatever plan you choose. “An improved diet doesn’t have side effects, like a prescription might, and it’s cost-effective — no co-pays required. And whereas a medication might target one specific health outcome, eating a healthy diet can reduce your health risks in a global way.”
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